Laparoscopic Reduction of Intussusception in Children: Role in Primary Reduction After Failed Non-Surgical Therapies

Assiut University

Status: Not yet enrolling

Conditions: Intussusception

Treatments: Procedure: Laparoscopy

Study type: Interventional

Funder types: Other

Identifiers

NCT06748326

Laparoscopy in Intussusception

Details and patient eligibility

About

Laparoscopic Reduction of Intussusception in Children: Role in Primary Reduction after Failed Non-Surgical Therapies.

Full description

Intussusception is one of the main abdominal emergencies in children. Its diagnosis is usually based on the clinical features and confirmed either by U/S and /or barium enema and CT scan in rare occasion. Since the introduction of the hydrostatic reduction of intussusceptions by Ravitch in 1848, it became the gold standard management. However surgical intervention is required if this and other non-operative approaches fail. This typically involves 10 to 20% of cases. Early on, the approach has been through an open laparotomy and manual reduction of intussusception. Later, the introduction of the laparoscopy in the paediatric surgical field has added another dimension to the management of intussusception. In addition to its confirmed general benefits of less pain, better cosmoses, and low long-term risk of adhesive bowel obstruction, it also can be a diagnostic modality in certain cases, primary reduce the intussusception and in some cases to resect the pathological lead point or the damaged segment of bowel. The laparoscope allowed the surgeons to avoid unnecessary open procedures in cases of spontaneous reduction following enema reductions, obviating the need for an open procedure in up to 30% of cases. Despite of all mentioned above, its effectiveness has been questioned.

Enrollment: 20 estimated patients

Sex: All

Ages: 1 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 1. childs aged 1 year to 12 years with intussusception who failed the hydrostatic reduction.

Exclusion criteria

• 1. Childs with Bad general conditions ( coagulopathy, haemodynamic instability, and severe cardiopulmonary diseases).

2. Known primary disease e.g. lymphoma and major congenital anomalies. 3. Previous abdominal surgeries.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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20 participants in 1 patient group

Laparoscopic reduction of intussusception in children

Other group

Description:

The abdomen is insufflated through an umbilical ring incision and a trocar is inserted to act as a camera Port. Two other ports for manipulation are placed depend on the position of the intussusception either in the right lower quadrant and the left upper quadrant or both the upper left and lower left quadrants of the abdomen. These ports position is assuming that radiological reduction has carried the intussusceptum to the right colon. Two atraumatic bowel clamps are used for bowel manipulation. The reduction is achieved by traction placed on the proximal bowel (intussusceptum) out of the distal segment (the intussuscepien).

Treatment:

Procedure: Laparoscopy